Odd SOC

[KateRN1]

I went to do a SOC with a new-ish RN for a ride-along. We had a referral for a pt at an ALF who needed PT, OT, and nursing. I'll spare you the uncomfortable details of the whole process, but let's just say it was a taxing effort. At the end of it all, I called the physician of record to notify of elevated (stroke level) blood pressure and pt c/o pain without any prn pain meds. The ALF director called me 10 minutes later to say that the physician was livid that I had called him, that I shouldn't have called him as she had told me he was out of town and unavailable, and that he gave her a verbal order to discontinue home care.

Talk about an educational experience. Never had that happen before.

[caliotter3]

Wow. At the right time, that probably would have elicited a few tears of sadness from me. Sometimes we just can't win for losing.

[Lucky724]

ok - so wasn't there someone else on call for him? What were you suppose to do? Let the patient possibly stroke and remain in pain? You did the right, ethical thing..too bad the MD and ALF director didn't.

[KateRN1]

Yeah, I did the right thing. No sweat there (or tears). I left out a lot of details for brevity's sake, but expect to hear from the marketer on Monday and will most likely get reamed for losing that facility as a potential referral source. Waaah. I don't care. He's not gonna be standing with me at the hearing in front of the board of nursing when I have to defend myself for not reporting. I did what was right and that's all there is to it. I'm still concerned about the patient, though, who isn't receiving her medications appropriately, has unaddressed pain issues, isn't competent to sign for herself, and signed over all her SS benefits to this ALF. Methinks there's something fishy going on here. And I am so thankful I had a witness to it all. That almost never happens.

[OkieeRN]

Sounds to me like an APS referral is in place...